Utilization Review Coordinator

Sedgwick

. Access, triage, and assign cases for utilization review .

Posted 10/20/2026full-timeRemote • Florida • United StatesJuniorMid-Level💰 $18 - $20 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in utilization review processes, including knowledge of medical and insurance terminology, ICD9 and CPT coding, and strong organizational skills. Proficient in data entry and maintaining data integrity while providing excellent customer service in a medical environment.

Highest-signal resume keywords

Utilization ReviewICD9 CodingCPT CodingCustomer ServiceData Entry

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Utilization ReviewICD9 CodingCPT CodingClaims ProcessingData Entry

Soft Skills

Excellent CommunicationOrganizational SkillsDetail OrientedInterpersonal SkillsTeam Collaboration

Tools & Technologies

Clinical Management SystemsMicrosoft Office

Industry Keywords

Medical TerminologyWorkers CompensationDisability ClaimsLiability Claims

About the role

Key responsibilities & impact

Access, triage, and assign cases for utilization review
Respond to telephone inquiries, provide accurate information, and triage as necessary
Enter demographics and utilization review information into claims or clinical management systems
Maintain data integrity
Obtain necessary information for utilization review processing from internal and external sources according to policies and procedures
Distribute incoming and outgoing correspondence, faxes, and mail
Upload review documents into the paperless system as necessary
Support other units as needed
Perform other duties as assigned
Support the organization's quality programs

Requirements

What you’ll need

High School diploma or GED required
Two (2) years of administrative experience or equivalent combination of experience and education required
Customer service in medical field preferred
Workers compensation, disability and/or liability claims processing experience preferred
Knowledge of medical and insurance terminology
Knowledge of ICD9 and CPT coding
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Strong organizational skills
Detail oriented
Good interpersonal skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies

Benefits

Comp & perks

Three medical plans to choose from
Two dental plans to choose from
Vision insurance
Tuition reimbursement eligibility
401(k) plan with 50% matching on contributions up to the first 6% saved
4 weeks PTO in the first full year
Disability insurance
Life insurance
Employee assistance program
Flexible spending account or health savings account
Other additional voluntary benefits
Work-life balance
Reasonable accommodations when applicable and appropriate